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Biomedical subjects

T Koike

Publications and source records attributed to T Koike.

At least 559 records · Page 31Linked to original sources

[Clinical assessment of urinary free L-fucose levels].

We measured urinary levels of free L-fucose in healthy subjects, patients with benign diseases, and patients with cancer using an automated analyzer and a newly isolated L-fucose dehydrogenase, and evaluated the clinical usefulness of the results. The values obtained were corrected for urinary creatinine as micromoles per gram of creatinine. The cutoff value, set at the mean + 2SD for the healthy subjects, was 250 mumol/g.Cr. Patients with gallbladder cancer, bile-duct cancer, liver cancer, pancreatic cancer, or cirrhosis of the liver had significantly higher levels of L-fucose than the healthy subjects. The diagnostic sensitivity for these five diseases, taken together, was 68% (144/213). Specificity for the detection of cancer was calculated by use of false positives for patients with cholelithiasis, hepatitis, and pancreatitis: it was 73% (76/104). Diagnostic accuracy for these seven diseases taken together was therefore 69% (220/317). We compared the positive ratio of the L-fucose level with that of the tumor markers AFD and CA19-9. The positive ratio of an L-fucose value above the cutoff was higher than the positive ratio of either marker in bile-duct cancer, gallbladder cancer, liver cancer, and pancreatic cancer. The results suggested that the urinary levels of free L-fucose reflected the metabolism of sugar chains of glycoconjugates, and may be usefully clinically as a tumor marker.

Biomarkers, Tumor↗

Stress platelets in normal individuals and patients with idiopathic thrombocytopenic purpura.

To test the hypothesis that stress platelets (SPs) described by Tong et al. in rats may be a parameter of young platelets in humans, we examined and characterized SPs in normal individuals and in patients with idiopathic thrombocytopenic purpura (ITP). Our results indicated that SPs comprise about 1.2% of the circulating platelets in normal individuals and 2.6% in ITP patients. The configuration of SPs as well as of various irregular forms of circulating platelets was found to be supported by synergism of both the platelet microfilaments and microtubules. SPs showed some segmentation, the degree of which was similar in normal individuals and ITP patients, and they underwent further segmentation during in vitro incubation, mainly promoted by microtubules, so that they sometimes appeared like discoid platelets in a chain. These observations suggest a new mode of production of discoid platelets in the circulation. Thus, identification and enumeration of SPs may be useful for evaluating thrombocytopoiesis in humans.

Adult↗

[Evaluation of implantation of a cancer chemotherapeutic vascular access device: report of 91 cases].

Between April 1984 and December 1990, 91 patients with advanced cancer were implanted with vascular-access-devices 97 times. The results were as follows. When the patients were divided into two groups according to the implantation, namely the earlier (until December 1986) and later (from January 1987) periods, the earlier patency rate was higher than later due to improvement of instruments and progress in the implantation technique. There was no significant difference in the rate of patency or complications between the abdominal and femoral method, but the femoral method had some subcutaneous hematomas. The direct femoral pathway is less invasive, correct and effectively therapeutic method.

Catheters, Indwelling↗

[A case of dissecting aneurysm of the basilar artery extended from the top of the basilar artery to the proximal part].

A rare case of the dissecting aneurysm of the basilar artery is reported. A 48-year-old man was admitted to our hospital because of a sudden onset comatose state. An hour later he recovered consciousness with the residual disturbance of the vertical ocular movement. Computed tomogram on second day revealed low density lesions in the medial part of the bilateral thalamus, and the mesencephalic tegmentum and the cerebellar peduncle on the left side. Cerebral angiograms on the same day and 13th day showed a double lumen sign of the basilar artery and slight extension of the dissecting aneurysm, respectively. However, the cerebral angiogram 6 months after the onset revealed a little bit shrinkage of the aneurysm. The patient was treated conservatively and is in good condition with slight limitation of the downward gaze 10 months after the onset. We reviewed the clinical sign, cerebral angiogram, treatment and prognosis of the dissecting aneurysm of the basilar artery.

Aortic Dissection↗

[A case report of aortic wall reconstruction utilizing heparin-coated temporary bypass tube and roller pump system].

A 51-year-old man with stage IIIB (T4N2M0) adenocarcinoma of the lung underwent left pneumonectomy and aortic wall resection. In this operation a heparin-coated tube and roller pump system were used. Advantages of a heparin-coated tube and roller pump system for temporary bypass are as follows. 1) simple operative procedure. 2) controllable bypass flow. 3) no need for anticoagulants.

Adenocarcinoma↗

[Megakaryoblastic transformation associated with disseminated intravascular coagulation in the course of polycythemia vera: a case report].

A 57-year-old male who had suffered from polycythemia vera (PV) and had been treated with pipobroman, carbazilquinon and busulfan for ten years presented with fever. CBC revealed anemia and thrombocytopenia without an increase of leukemic blasts (WBC, 7,700/microliters, RBC 294 x 10(4)/microliters, Hb 9.1 g/dl, Plt 1.5 x 10(4)/microliters). Bone marrow aspiration resulted in dry tap. Bone marrow biopsy showed hyperplastic marrow with fibrosis and no increase in leukemic blasts. Eleven days later the patient became leukemic and he died of DIC. Blast cells showed a high nucleo-cytoplasmic ratio, basophilic cytoplasm and cytoplasmic blebs. Cytochemical and immunophenotype analysis of the blast cells showed the following results; myeloperoxidase (-), chloroacetate esterase (-), Sudan black (-), acid phosphatase (+), acetate esterase (+), PAS (+), HLA-DR (+) and GPIIb/IIIa (+). Platelet peroxidase reaction on electron microscopy was positive in perinuclear spaces and endoplasmic reticulum. A diagnosis of megakaryoblastic transformation of PV was made. Although acute myelogenous leukemia has been shown to develop occasionally in the course of PV, acute megakaryoblastic leukemia with DIC following PV is a very rare condition.

Blast Crisis↗

[Diagnosis and treatment of disseminated intravascular coagulation associated with neurosurgical diseases; a proposal of a new scoring system for DIC].

The occurrence of disseminated intravascular coagulation (DIC) is not rare in neurosurgical patients. We investigated the therapeutic effects of gabexate mesilate (FOY) for DIC or DIC preparatory state in 70 cases. Underlying diseases were head injuries in 31 cases, intracranial hemorrhages in 19, subarachnoid hemorrhages in 10, cerebral infarctions or embolisms in 5, brain tumors in 3 and other diseases in 2. DIC or DIC preparatory states were induced by severe brain damage (26 cases), infection (26 cases), failure of other organs (6 cases), shock (5 cases), and others. On the basis of the clinical coagulation studies of these patients, we retrospectively established a new scoring system for DIC (neurosurgical DIC score) associated with neurosurgical diseases and evaluated whether it was useful. Because the original DIC score proposed by the Research Committee on Blood Coagulation Disorders supported by the Japanese Ministry of Health and Welfare was not correlated with the level of consciousness representing the primary brain damage, it was likely to be underestimated in neurosurgical patients. Therefore, we included the level of consciousness with a new DIC scoring system. The neurosurgical DIC score was calculated from platelet count (score 0-3), FDP (score 0-3) and the level of consciousness (score 0-2), and was diagnosed as DIC preparatory state if it was 3, calculated from 2 of the 3 parameters, and as DIC if it was over 4. The score should be checked twice if it was 3, especially after operation. The neurosurgical DIC score was significantly correlated with the original DIC score.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Natural interferon-alpha induced cytogenetic complete remission in a patient with chronic myelocytic leukemia, diagnosed in early chronic phase with basophilia and normal blood cell counts].

A 57-year-old woman visited to our hospital complaining of paresthesia in the right leg. She had no abnormal physical findings. However, the peripheral blood examination demonstrated 7% basophilia with 8000/microliters WBC count and decreased neutrophil alkaline phosphatase activity (score 37, rate 19%). She was diagnosed as Ph1 chromosome positive CML in early phase by the chromosomal analysis of bone marrow cells. She received subcutaneous injection of natural interferon-alpha at a dosage of 600 x 10(4) IU daily from March 10, 1987. The dosage and administration interval were gradually reduced and prolonged. Since November 1988, weekly injections of 300 x 10(4) IU has been administered as maintenance therapy. Cytogenetic improvement was seen at 4 months after the start of IFN. Disappearance of Ph1 chromosome positive cells was observed on December 11, 1987. It was suggested that the administration of IFN from the early chronic phase played an important role in the control of the disease.

Basophils↗

Evidence that nerve growth factor dependence of sympathetic neurons for survival in vitro may be determined by levels of cytoplasmic free Ca2+.

Developing sympathetic neurons established in the presence of nerve growth factor (NGF) die in vitro after acute withdrawal of NGF. This in vitro model mimics the physiological situation in which neurons die during development or after axotomy when trophic support becomes insufficient. We have previously shown that depolarizing agents including high K+ and cholinergic agonists prevent neuronal death induced by acute deprivation of NGF in vitro. Based on this finding, a Ca2+ set-point hypothesis was proposed for the degree of neuronal dependence on tropic factor in vitro. Here we have examined the validity of this hypothesis by measuring the level of cytoplasmic free Ca2+ ([Ca2+]i) with fura-2 as a probe for monitoring Ca2+. (i) There was a good correlation between cell survival in the absence of NGF and [Ca2+]i levels of young sympathetic neurons (1 week in vitro) chronically exposed to various concentrations of extracellular K+, which shows that 50% survival occurred at approximately 184 nM [Ca2+]i and complete survival, independent of trophic support, occurred at approximately 240 nM [Ca2+]i. (ii) The basal level of [Ca2+]i of sympathetic neurons was relatively low (93.0 +/- 10.5 nM) at days 6-8, then increased with incubation time, and finally reached a plateau level of 241 +/- 7 nM at around week 3, when the neurons became independent of NGF for survival. (iii) Sympathetic neurons maintained in the presence of high or low concentrations of Ca2+ displayed altered trophic dependence. Thus, these findings are consistent with this Ca2+ set-point hypothesis for the degree of NGF dependence of sympathetic neurons for survival in vitro.

Animals↗

Successful treatment of chronic idiopathic neutropenia using recombinant granulocyte colony-stimulating factor.

A patient with chronic idiopathic neutropenia, who had been suffering from repeated infections, was successfully treated with recombinant granulocyte stimulating factor (rhG-CSF). Subcutaneous injection of 30 micrograms/m2 rhG-CSF every two days was sufficient to maintain the neutrophil count at approximately 1,000/microliter. The patient has lived without any evidence of infection for the last 10 months using that treatment. There were no side effect caused by rhG-CSF and antibodies against G-CSF were not detected in the patient's plasma.

Granulocyte Colony-Stimulating Factor↗

Serial angiography in a spontaneous dissecting anterior cerebral artery aneurysm.

Intracranial dissecting aneurysms are uncommon, and little is known concerning the natural history of these lesions. In this paper we present a rare case of dissecting aneurysm of the anterior cerebral artery in which a true diagnostic sign of "double lumen" was demonstrated. Sequential changes in angiographic features shown on serial angiographic studies are described, and diagnosis is briefly discussed.

Aortic Dissection↗

Gene transfer into human leukemia cell lines by electroporation: experience with exponentially decaying and square wave pulse.

The efficiency of gene transfer into human leukemia cell lines by electroporation was investigated. For both transient expression (beta-galactosidase gene) and stable transformation (neomycin resistance gene), the transfer efficiency into leukemia cell lines using a square wave pulse was superior to that using an exponentially decaying wave. The transfer rate of pMoZtk (containing beta-galactosidase gene) into K562 by electroporation using a square wave was approximately 5%, compared with 1% by an exponentially decaying pulse. Whereas the transfer rate of pMAM-neo into K562 by electroporation using an exponentially decaying pulse was less than 10(-5), a square wave generated much more efficient introduction rate of nearly 10(-3). In the other leukemia cell lines also, some square wave yields were better than exponential yields and all square wave yields were at least as good as the exponential yields.

Blotting, Southern↗

Molecular definition of human beta 2-glycoprotein I (beta 2-GPI) by cDNA cloning and inter-species differences of beta 2-GPI in alternation of anticardiolipin binding.

Human beta 2-glycoprotein I (beta 2-GPI) is involved in cardiolipin (CL) binding of anticardiolipin antibodies (aCL) in systemic lupus erythematosus (SLE). We examined the inter-species differences of beta 2-GPI in alternation of CL binding of aCL. beta 2-GPI preparations were obtained from human, bovine, and rat sera by sequential CL--polyacrylamide affinity, DEAE--cellulose, and anti-human IgG-conjugated Sepharose CL-4B column chromatography, and they had apparent molecular weights of 50, 53, and 55 kDa respectively. Human beta 2-GPI not only enhanced CL binding by aCL in SLE but also depressed it by those in syphilis. Either bovine and rat beta 2-GPI exerted no or quite small inhibition of the binding of syphilitic aCL compared with human beta 2-GPI whereas all three species of beta 2-GPI generated binding of aCL in SLE to a similar degree. Further, a complete cDNA clone, p beta 2-GPI, was isolated from a human hepatoma cell line, HepG2, and its nucleotide sequence was analyzed. The sequences of bovine and rat counterpart molecules (beta 2-GPI) are highly homologous to that of the deduced sequence, and their corresponding regions are 84.0 and 82.5% identical to the complete domain and to the amino acid sequence 53-326 of human beta 2-GPI respectively. One of major differences appears at position 154 in human beta 2-GPI, and might be associated with the inhibitory effect on the binding of syphilitic aCL. The sequencing analysis of these beta 2-GPI proteins might provide leads to functional sites of domains which would be associated with such serological phenomena.

Amino Acid Sequence↗

Myelodysplastic syndrome with myelofibrosis: myelodysplastic syndrome as a major primary disorder for acute myelofibrosis.

Seven cases of myelodysplastic syndrome with myelofibrosis, which is defined using the following criteria: (1) pancytopenia with less than 5% blasts in the peripheral blood; (2) minimal or no splenomegaly; (3) myelofibrosis with cellular marrow; (4) absence of diffuse proliferation of blasts in the bone marrow; and (5) presence of myelodysplastic features of bone marrow or peripheral blood cells, are presented. They were in the range of 52-82 years old and consisted of 3 males and 4 females. Six out of 7 cases developed into acute leukaemia after 5 to 8 months from the onset and died from between 2 weeks to 8 months from the evolution to leukaemia. The type of leukaemia was acute myeloblastic in 3 patients, and acute myelo-megakaryoblastic in 3 patients. Another patient died of severe hepatic injury after 5 months from the onset of the disease. These findings revealed that the complication of myelofibrosis in the patients with myelodysplastic syndrome was an indicative sign of rapid progression to overt leukaemia or otherwise poor prognosis for survival. In addition myelodysplastic syndrome is thought to be major primary disorder for acute myelofibrosis. Myelodysplastic syndrome with myelofibrosis is closely associated with the neoplastic proliferation of megakaryoblasts in a considerable number of patients.

Acute Disease↗

Protein losing enteropathy associated with collagen diseases.

Four patients with collagen diseases are described, who developed protein losing enteropathy in the course of their disease. Their protein losing enteropathies subsided after treatment with 60 mg/day oral prednisolone. Immunohistological studies of the small intestine showed deposits of C3 in the capillary walls of villi in two patients. Increased capillary permeability due to autoimmune phenomena may have a role in the pathogenesis of protein losing enteropathy associated with collagen diseases.

Adult↗